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中华妇幼临床医学杂志(电子版)

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2016, Vol. 12 ›› Issue (06): 699 -704. doi: 10.3877/cma.j.issn.1673-5250.2016.06.015

Special Issue: ；

Original Article

Clinical analysis of right bundle branch block pattern for children and adults electrocardiogram

Tong Liu1, Fang Qin1, Zhijie Zheng2, Lina Qiao3, Yongyi Lu3, Li Wei3,†()   

  1. 1. Department of Cardiology, Chengdu First People′s Hospital, Chengdu 610041, Sichuan Province, China
    2. Department of Electrocardiogram, West China Fourth Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
    3. Department of Pediatrics, West China Second Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2016-03-09 Revised:2016-11-04 Published:2016-12-01
  • Corresponding author: Li Wei
  • About author:
    Corresponding author: Wei Li, Email:
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Objective

To analyze the age, etiologic distribution, combined type of block and the QRS wave width of electrocardiogram in children and adults with right bundle branch block (RBBB).

Methods

A total of 830 cases of outpatients and inpatients who were diagnosed as RBBB by electrocardiogram in Chengdu First People′s Hospital, West China Second Hospital of Sichuan University and West China Fourth Hospital of Sichuan University from January to December in 2013 were selected as the subjects. According to the age, they were divided into children group (n=330, all <18 years old) and adults group (n=500, all ≥18 years old). The age, etiologic distribution, combined types of blocks, QRS width of two groups were analyzed by statistical methods.

Results

①The age of RBBB patients in children group was mainly distributed in 3 to 7 years old, accounting for 40.0% (132/330) of the total number of children group. The age of RBBB patients in adult group was mainly distributed in 50 to 70 years old, accounting for 40.8% (204/500) of the total number of adults group. ②Congenital heart disease was the most common cause of RBBB in children, preoperative and postoperative congenital heart disease patients accounted for 29.1% (96/330) and 56.4% (186/330), respectively in children group. Adults with chronic lung disease or a clear history of heart disease accounted for 65.6% (328/500) in adults group. ③The incidence of RBBB combined with other types of block in children group and adults group was 16.4% (54/330) and 50.4% (252/500), respectively. There was no significant difference in the constituent ratio of RBBB combined with other types of blocks in children and adults group (χ2=0.250, P=0.993). RBBB combined with left anterior branch block (LAFB) was the most common combined type of blocks both in adults and children group. ④The width of QRS in children with incomplete right bundle branch block (IRBBB) was (78.2±12.6) ms, which was lower than (98.9±9.3) ms in adults group, and the difference was statistically significant (t=-3.193, P=0.013). The QRS width of children with complete right bundle branch block (CRBBB) was (118.4±8.9) ms, which was significantly lower than (148.2±21.4) ms in adults group, and the difference was statistically significant (t=-3.214, P=0.012).

Conclusions

The distributions of RBBB in age, etiology, QRS width of electrocardiogram in children and adults are different. But there is no difference in the combination of other types of blocks betweeen children and adults with RBBB.

Key words: Bundle branch block, Electrocardiography, Child, Adult
表1 儿童组与成年人组右束支传导阻滞患者年龄分布情况
组别 例数 年龄(岁) 构成比[例数(%)]
儿童组 330 ? ?
? ? 0～1 36(10.9)
? ? >1～3 54(16.4)
? ? >3～7 132(40.0)
? ? >7～12 72(21.8)
? ? >12～18 36(10.9)
成年人组 500 ? ?
? ? >18～35 32(6.4)
? ? >35～50 70(14.0)
? ? >50～70 204(40.8)
? ? >70 194(38.8)
表2 儿童组与成年人组右束支传导阻滞患者病因分布情况
组别 例数 病因 构成比[例数(%)]
儿童组 330 ? ?
? ? 先天性心脏病术前 96(29.1)
? ? 先天性心脏病术后 186(56.4)
? ? 病毒性心肌炎 22(6.7)
? ? 心包积液 8(2.4)
? ? 无心脏病史 18(5.4)
成年人组 500 ? ?
? ? 慢性肺部疾病 134(26.8)
? ? 原发性高血压、冠心病 88(17.6)
? ? 先天性心脏病术前 36(7.2)
? ? 先天性心脏病术后 70(14.0)
? ? 不明确是否为心脏病变 172(34.4)
表3 儿童组与成年人组右束支传导阻滞合并其他阻滞类型分布情况[例数(%)]
组别 例数a RBBB＋LAFB RBBB＋Ⅲ度AVB RBBB＋Ⅰ度AVB RBBB＋LAFB＋Ⅰ度AVB
儿童组 54 42(77.8) 2(3.7) 4(7.4) 6(11.1)
成年人组 252 204(81.0) 20(7.9) 16(6.3) 12(4.8)
χ2值 0.250
P值 0.993
表4 2组右束支传导阻滞患者QRS波宽比较(ms，±s)
组别 例数 IRBBB CRBBB t值 P值
儿童组 330 78.2±12.6 118.4±8.9 －72.358 <0.001
成年人组 500 98.9±9.3 148.2±21.4 －59.266 <0.001
t值 ? －3.193 －3.214 ? ?
P值 ? 0.013 0.012 ? ?
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